Friday, August 29, 2008

Eyes On The Prize

Yesterday was a mix of joy and agony. Our plight continues to find the vet who can and will treat Carmella's Central Nervous System.

After two weeks of this increase in jerking and seeing Dr. Brantly in the interrum, we went to Dr. Norwood's office at 4:30. Felicia was happier than I've ever seen her, smiling and even came out from behind the counter to pet and play with Carmella. It had really sunk in just how much a miracle her treatment with the shot of NDV was for her body, and it seemed that the entire staff was in a festive mood. They all commented on how beautiful she was and how much she'd changed. She now weighs 24 LBS. Only two weeks ago she was just 18 LBS.

Once we'd been put in a room, the female vet tech came in (I can't remember her name, but she is the best one). She asked me if I had had any luck with Dr. Brantly doing the procedure and I said that I thought he was going to do it, but he changed his mind, but that we're still looking. She understood the ramifications of all this, and although happy with the results in the body, knew she was not through yet with what needed to be done in order for the cure to be complete. She commented to another assistant standing in the doorway that this dog was a miracle, beaming from ear to ear.

Dr. Norwood came in and started checking Carmella's reflexes, looked into her eyes, and saw her walk down the hall. She did pretty well, but stumbled at the end once when coming back to the room.

Carmella was in almost constant motion and we had to get her to calm down before he would see the jerking. Eventually she stayed still enough that it started up again and he definitely saw it.

He told me that he'd had no luck with Tuskegee, and was getting pessimistic about whether any of these Universities would help unless they were already doing studies on Distemper. He was still very mousey about calling them and said he'd do it but it could turn out to be another dead end and he couldn't promise anything.

"Like with Dr. Johnson, I can't make them do it."

"Well just make an empassioned plea, show them all that you've documented about her success from the NDV in the body, and advocate as if it were your own mother who was sick and needed treatment."

At this point there were no other real prospects on the table, so I figured this had at least as much chance as anything we've already tried. Up until now we'd just been approaching private practice vets. If this is still considered "experimental" then so be it; we'd just take her somewhere where they do experimental work. Seeing as that UGA is considered one of the best veterinary schools in the Southeast, they should be able to handle this. We just need to get them to try.

Dr. Norwood seemed to be angling at cutting our losses and just going with the partial cure (what we'd gotten in the body).

"The myoclonis could be permanent damage to the myelin and white matter, just residual effects of the disease."

"If that were the case then it wouldn't be increasing over time."

"We could give her Klonazapam, a veterinary version of an anti-seizure drug used in humans." I already knew what it was. Both myself and my son had taken it in the past for our seizures.

"The point is, that if the virus got into the CNS, which it would have to in order to cause that damage, then being in such an enclosed area it would still be present. To assume it's no longer there would just be guessing".

Dr. Norwood was rationalizing to make all the rejections by all the vets we'd appraoched easier to swallow. Maybe for him it would be easier to tell himself that the job was complete, but the idea of leaving this to the imagination and then ending up with worse problems down the road because we made the wrong assumption didn't sit well with me and it didn't make sense based on the biochemistry of the disease.

The CNS is a veritable fortress, and with good reason. It protects the most vital part of the body, the brain; the control tower on which all other function depends. An infection with the deadly Distemper virus is not something you want to leave sealed up for eternity in a dog's head, on a gamble that it will have mercy and not do any further damage. You can hide from it, reframe it, pretend it's not there, and remove yourself from watching its ravages, but it doesn't change the truth. Either it's there or its not. Once it gets in it doesn't just decide its had enough and go away. It's stuck in there and can adapt, hide, and mutate. It gets in via the lungs by piggybacking onto cells that already are able to cross the blood-brain barrier, but it cannot leave the same way it came.

By the end, Dr. Norwood had to admit that the only way to isolate and be sure to eradicate the virus would be to do a spinal tap. He said that UGA would want to do their own tests and probably wouldn't accept his, and it would involve spending more money. I replied that if they ended up doing the procedure then it would be worth it, and besides, if she does have permanent damage the neuro vets there would be the ones to do imaging tests to find any lesions that are there and assess the extent of the damage. If we want to weed out what is damage and what is active disease that's the way to do it.

Dr. Norwood agreed to try again to call UGA's referral coordinator the next day but had been unable to get through the day I came in.

I was up until around 5:00 AM this morning and was too desolate to post an update, and my muscles were starting to ache so I went to bed.

Dr. Norwood was in with a patient when I called this afternoon. Gwen, the office manager took a message that I was asking about the referral to UGA and said she'd have him call back, but he didn't.

I hope he's not wimping out when we need his support the most. When it's all done there will be time to celebrate, congratulate and let our guard down, but until then we are still on high alert. Failure is not an option. Carmella's life may depend upon our level of endurance and ability to go the full nine yards. Perhaps UGA's symbol; the Bulldog, should be our guiding example.


BeadedTail said...

I just read this post and previous ones about Carmella. How heartbreaking to go through all this but I can tell how much you love her and will stop at nothing to help her get well again. Carmella is lucky to have you in her corner and you are very lucky to have beautiful Carmella. I am sending wishes that UGA will help Carmella. I will keep her in my thoughts.

Sending puppy hugs!

Giftbearer said...

Thanks, Sharla, and I hope you will keep reading.